| NPI | 1619488566 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: ID LCPC7505) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: ID LPC-6680) |
| Enumeration Date | 2017-10-18 |
| Last Update Date | 2021-07-23 |